American College of Surgeons Oncology Group, Chicago, Illinois complementary or alternative medical (CAM) therapies by adults of all ages. Despite the common use of CAM therapies for back pain, little is known about how they compare with each other or with conventional medical therapies in terms of effectiveness and cost. Studies evaluating back pain treatments for older adults are particularly rare. This study will lay the groundwork for a full-scale trial that evaluates the relative effectiveness and costs of three promising relaxation-related techniques (massage, tai chi, and meditation) that are appropriate for both older and younger adults with chronic low back pain. During Phase I, we will develop, test and refine specific components of a randomized clinical trial evaluating tai chi, massage and meditation for chronic back pain. This will include specification of treatment and comparison groups, subject selection criteria, recruitment and retention strategies, and development of instruments for measuring outcomes. During Phase II, we will use the study components developed during Phase I to conduct a pilot study designed to evaluate the three relaxation-related treatments. Thirty persons with chronic low back pain will be randomized to each of the following groups: tai chi, massage, meditation and continued usual care. The subjects randomized to each intervention will be divided equally between persons over and under age 65. (Recruitment will include subjects in their 70s, 80s, and older.) The pilot study will permit us to identify and resolve unanticipated problems and to estimate the sample sizes required for an adequately powered full-scale trial. At the conclusion of this project, we will be well positioned to prepare a competitive grant proposal to evaluate relaxation-related CAM therapies for treating both older and younger adults with chronic low back pain.